FOR IMMEDIATE RELEASE
December 23, 2020

 

STATEMENT FROM EXECUTIVE DIRECTOR: MICHAEL REFF
Contact: Kevin Scorsone | NCODA Legislative & Policy Liaison
Phone: (919) 903-2057
Email: kevin.scorsone@ncoda.org
www.ncoda.org

MOST FAVORED NATION: TEMPORARY RESTRAINING ORDER ISSUED

NCODA has been in opposition of the Most Favored Nation (MFN) model for Medicare patients since it was announced late last month. The model would negatively affect patient access to Part B drugs – the anti-cancer (oral and infused) treatments that are administered in oncology practices.

Today, it was announced that US District Court Judge Catherine Blake (Maryland) issued a two-week temporary restraining order (TRO) which delays the implementation of the MFN model. The two-week reprieve allows the court time to consider implementing a preliminary injunction against the MFN model.

This mandatory 7-year payment model would establish reimbursement to providers based on an MFN price for the 50 highest cost Part B drugs. The MFN price would be phased in to replace the current ASP reimbursement model and would be based on international pricing from other similar countries.

This model would create a potentially insurmountable challenge for oncology practices, and it would hurt the people who matter most – the patients. NCODA continues to oppose this model and will monitor and update our membership as progress is made on this decision.

Michael Reff, RPh, MBA
Founder & Executive Director | NCODA, Inc.

Read the full release HERE.

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FOR IMMEDIATE RELEASE
December 18, 2020
STATEMENT FROM EXECUTIVE DIRECTOR: MICHAEL REFF

Contact: Kevin Scorsone, NCODA Legislative & Policy Liaison
Phone: (919) 903-2057
Email:
kevin.scorsone@ncoda.org
https://www.ncoda.org

MOST FAVORED NATION MODEL: NOT THE ANSWER FOR PATIENTS

NCODA is in opposition of the Most Favored Nation (MFN) model for Medicare patients that would negatively affect patient access to Part B drugs – the chemotherapy and infusion treatments that are administered in our community oncology member practices.

Scheduled to begin January 1, 2021, this mandatory 7-year payment model proposed to lower drug costs would establish reimbursement to providers based on an MFN price for the 50 highest cost Part B drugs.  The MFN price would be phased in to replace the current ASP reimbursement model and would be based on international pricing from other countries.

Under the MFN model, practices administering these drugs would be purchasing and administering these drugs at a cost exceeding the proposed MFN reimbursement.  These losses would be unsustainable and force practices to close their doors and send patients to more expensive treatment locations. Life-saving treatment options would not be as readily available to many seniors who would be forced to forgo treatment.

We are still in the midst of the COVID-19 pandemic which has resulted in thousands of deaths. The MFN model will promote additional limitations on seniors’ access to standard of care therapy for their cancer diagnoses.

NCODA does not support the implementation of this mandatory model on cancer patients and the oncology community. Not only would this model create a potentially insurmountable challenge for oncology practice it would hurt the people who matter most, the patient.

Our Passion for Patients is not just a statement it continues to be our Mission and focus.


Michael Reff, RPH, MBA
Founder and Executive Director

Full Press Release HERE

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FOR IMMEDIATE RELEASE
December 11, 2020
STATEMENT FROM EXECUTIVE DIRECTOR: MICHAEL REFF

Contact: Kevin Scorsone, NCODA Legislative & Policy Liaison
Phone: (919) 903-2057
Email:
kevin.scorsone@ncoda.org
https://www.ncoda.org


SUPREME COURT RULES UNANIMOUS: REGULATES PHARMACY BENEFIT MANAGERS
Decision confirms that states will have the right to regulate; brings clarity and optimism

Yesterday, December 10, 2020, the United States Supreme Court (Rutledge, Attorney General of Arkansas VS Pharmaceutical Care Management Association) unanimously decided that states can regulate Pharmacy Benefit Managers. Pharmacy Benefit Managers (PBM’s) are companies that oversee the prescription drug benefits on behalf of insurance companies along with Medicare Part D drug plans.

NCODA believes that this decision by the Supreme Court marks a significant day for pharmacists and pharmacies everywhere. Most importantly, this ruling provides patients the ability to have complete transparency when dealing with Pharmacy Benefit Managers and track the cost of their medications.

Read the full press release here.

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MISSION STATEMENT/PHILOSOPHY:

Our Mission

Helping people live the healthiest lives possible®

Our Vision

Be a model health system by providing extraordinary care and superior service at an affordable cost.

LOCATION(S):

MEDICAL ONCOLOGY Offices

3131 La Canada Street, Ste 140

Las Vegas, NV 89169

(702) 735-7154

(702) 735-7153 Fax

 

2650  Tenaya Way, Ste 201

Las Vegas, NV 89128

(702) 735-7154

(702) 869-8103 Fax

 

8285 W. Arby Avenue, Ste 100B

Las Vegas, NV 89113

(702) 735-7154

(702) 405-1860 Fax

RADIATION ONCOLOGY

 

6160 S Fort Apache Rd

Las Vegas, NV 89148

(702) 730-5480

(702) 730-5495 Fax

 

PRACTICE DETAILS (how many providers, how many employees, etc):

3 Medical Oncology Clinics

8 Hem/Oncs with 4 Advanced Practitioner Providers;

1 Radiation Oncology Clinic

1 Rad Onc, 1 Rad Onc Nurse Practitioner

75-80  employees

INTRODUCTION TO PHARMACY SERVICES STAFF W/ BRIEF BIO:

2  Medically Integrated Dispensaries

2 Dispensing Technicians

RN Navigator

Financial Counselor

*The only Celgene REMS certified MID in the State of Nevada

DISPENSING TYPE (RETAIL VS DISPENSARY):  MID

SERVICES PROVIDED (BONE MARROW, RADIATION, CHEMO):

Radiation Oncology

Medical Oncology

Clinical Hematology

Chemotherapy

Immunotherapy

On-site Laboratory Services

On-site PET/ CT scanning

Physician Dispensing Pharmacy Services

WHY DID  YOU JOIN NCODA?

We needed guidance from a group of experts from the Pharmacy world  to optimize our MID program in physician office setting. The NCODA intuitive tools and oncology specific drug educational resources has made our caregivers’ daily work easier which are then passed along to our patients ensuring they are getting highest level of quality care.

HOW DID YOU BECOME A MEMBER?

Back in 2015, I attended an educational presentation on “Promoting Patient Adherence to Oral Chemotherapy” presented by Mike Reff here in Las Vegas. He showed real life scenarios and pointed out the ongoing challenges in managing Oral treatment for Cancer in a physician office setting.  He invited us to join NCODA and explained the services provided. It was a unique offering as Oral Oncolytics has started gaining traction in the industry. I took the invitation from Mike Reff to sign me up and became a member.

HOW DID YOU HEAR ABOUT US?

Through an invitation from the founder, Mike Reff.

HOW CAN NCODA HELP YOU?

  • Continue to have a robust accessible Oncology specific drug educational resource to provide effective patient education ensuring they are getting highest level of quality care
  • Continued support in networking opportunities to share best practices and learn from each other

HOW WOULD YOU LIKE TO BE MORE INVOLVED WITH NCODA?

Will continue to assist in promoting the program as I have in the past. I actively attend GPO conferences, was able to network with other practices, I spread the word as to how NCODA has been there to help with Oncology resources for the practice and the patients. About 4 practices from our GPO joined NCODA and found it very helpful to be part of the association.

WHAT ARE SOME CHALLENGES YOU FACE NOW OR WILL FACE IN THE FUTURE OF ONCOLOGY?

EHR integration. There is still not a perfect EHR that could integrate with different systems in the local network. We belong to a huge multi-specialty group taking care of same group of patients in value based model. Other specialties are still operating under different EHR, PMS. Collecting data becomes a challenge when you are having to pull from different resources to come up with a true meaningful analytic report

 Financial toxicity. Majority of the new drugs in the market are very costly. For our geriatric population who only have government backed insurance, they cannot take advantage of the manufacturer copay programs and are faced with very high financial burden when the Foundation assistance fund is exhausted.

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FOR IMMEDIATE RELEASE

Cazenovia, NY – On November 12th, after feedback from healthcare professionals, UnitedHealthcare (UHC) announced that the implementation of their Accumulator Adjustment – Medical Benefit Program for their commercial members will NOT take effect on Jan. 1, 2021. This program would have prevented manufacturer assistance and co-pay programs from being accounted towards patient deductibles and the resulting out-of-pocket maximums.

NCODA was the first organization to develop a resource for healthcare providers and patients regarding co-pay accumulators in 2018. Over 10,000 of these tri-fold resources have been distributed across the country to date. We have always brought education of these accumulator programs to our membership and other stakeholders. NCODA has hosted live webinars on this topic with practice and industry leaders, and we have also created easy-to-understand educational videos.

We are proud to continue supporting our membership through timely education on the impact of this issue and others like it that result in obstacles to patient assistance.

To request copies of our proprietary accumulator tri-fold resource, click here. NCODA will keep our members and stakeholders informed and updated of any future developments.

Email us at contact@ncoda.org for more information.

See official press release here.

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